Kirurško zdravljenje zapletov Crohnove bolezni

Hazabent M, Ivanecz A, Koželj M, Potrč S, Kavalar R.
Med Mes 2007; 3:65-70.

Kirurško zdravljenje
zapletov Crohnove
bolezni

Crohnova bolezen je kronična vnetna bolezen, ki lahko prizadene katerikoli del gastrointestinalnega trakta in jo diagnosticiramo s kombinacijo kliničnih, bioloških in morfoloških značilnosti. Kirurško zdravljenje Crohnove bolezni je simptomatsko in ga izvajamo le ob nastopu zapletov, kot so krvavitev, perforacija, absces, toksična dilatacija, obstrukcija in fistula. 90 % bolnikov s Crohnovo boleznijo bo slej kot prej potrebovalo operacijsko zdravljenje. Ileocekalna regija in ozko črevo sta najpogostejši mesti, ki potrebujeta kirurški poseg in sta prizadeti pri približno 40 % bolnikov, ki potrebujejo kirurško zdravljenje. Pri fistulah pride največkrat v poštev resekcija črevesa, v primeru multiplih stenoz pa strikturoplastika. Kolorektalni zapleti so redkejši in težje obvladljivi, prav tako so redki zapleti v zgornjem delu GIT, kjer pridejo v poštev predvsem premostitveni posegi. Zelo redki so urološki zapleti. Pri določenih zapletih se uveljavlja laparoskopski pristop, katerega uporaba je še predmet raziskav. V članku smo predstavili pregled operacij zaradi zapletov Crohnove bolezni v Splošni bolnišnici Maribor v obdobju 2000-2005.

Surgical management of Crohn's disease complications

Crohn's disease is chronic inflammatory disease that can affect any part of gastrointestinal system and is diagnosed by combination of clinical, biological and morphological features. Surgical management of Crohn's disease is symptomatic and is applied only in case of complication, such as bleeding, perforation, abscess, toxic dilatation, obstruction and fistula. In 90 % of patients with Crohn's disease are going to need surgery during their lifetime. Ileocecal region and small intestine most frequently need surgical management and are affected in 40 % of patients qho need surgery. Resection is most frequently used for fistulas, in case of multiple stenoses stricturoplasty is applied. Colorectal complications are rare and hard to manage, so are complications is foregut, where by-pass procedures are mostly used. Urologic complications are very rare. For some of the complications laparoscopic approach is used but this is still debatable. In this article we presented overview of operations of complications caused by Chron's disease in General hospital Maribor in period 2000-2005.

Ključne besede:

Crohnova bolezen, kirurško zdravljenje zapletov.

Key words:

Crohn's disease, Surgical management of disease complications.

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